Test bank for health and physical assessment in nursing 3rd edition by DAmico and barbarito download

Test bank for Health and Physical Assessment In
Nursing 3rd Edition by DAmico and Barbarito
Chapter 3: Wellness and Health Promotion
Question 1
Type: MCSA
The nurse held a smoking cessation class prior to the upcoming Great American Smokeout,
hoping to motivate many individuals to stop smoking by promoting self-efficacy. Which
statement made by a participant indicates the highest level of positive self-efficacy according
to the Health Belief Model?
1. “I think this time will be different.”
2. “I am going to do the best that I can, so that I won’t get lung cancer.”
3. “I am afraid of getting lung cancer like my father.”
4. “I know that this time I will quit smoking permanently.”
Correct Answer: 4
Rationale 1: Stating that this attempt at quitting smoking will be different shows a low level of
commitment to the action.
Rationale 2: Stating fear of getting lung cancer represents an internal cue to action, based on
the Health Belief Model.
Rationale 3: Referring to a family member with the disease represents an internal cue to
action, based on the Health Belief Model.
Rationale 4: Based on the Health Belief Model, self-efficacy refers to the level of confidence an
individual has about the ability to perform the activity. The client’s statement, “I know that this time
I will quit smoking permanently,” shows the highest-level determination and motivation.
Global Rationale: Based on the Health Belief Model, self-efficacy refers to the level of
confidence an individual has about the ability to perform the activity. The client’s statement
that he/she intends to make a permanent change shows the highest-level determination and
motivation. Stating that this attempt at quitting smoking will be different shows a low level of
commitment to the action. Stating fear of getting lung cancer and referring to a family
member with the disease represents internal cues to action, based on the Health Belief Model.
Cognitive Level: Applying
Client Need: Health Promotion and

Maintenance Client Need Sub:
QSEN Competencies: III.B.3. Base individualized care plan on patient values,
clinical expertise, and evidence.
AACN Essentials Competencies: I.1. Integrate theories and concepts from liberal
education into nursing practice.
NLN Competencies: Context and Environment: Health promotion/disease prevention.
Nursing/Integrated Concepts: Nursing Process: Evaluation
Learning Outcome: 3.3: Relate perspectives of health promotion to the individual, family,
and community.
MNL Learning Outcome:
Page Number: p. 49
Question 2
Type: MCSA
D’Amico/Barbarito Health & Physical Assessment in Nursing, 3/e


A couple seeks genetic counseling as both have a positive family history of sickle cell
anemia, and are concerned about the potential of having a child with this disease.
Which statement indicates that the couple wishes to participate in primary prevention?
1. “We need to both be treated for sickle cell anemia before we can have a baby.”
2. “We will have blood tests to determine if we are carriers.”
3. “We need to see a genetics counselor to discuss the potential for having a child with sickle
cell disease.”
4. “Neither one of us has sickle cell disease, so any baby we have will be safe from the disease
as well.”
Correct Answer: 3
Rationale 1: Indicating a need for treatment would be considered secondary or
tertiary prevention.
Rationale 2: Both individuals being tested for carrier status would be considered
secondary prevention, as it deals with early diagnosis of health problems.

Rationale 3: Primary prevention implies health and a high level of wellness for the
individual. Seeking out a genetics counselor to discuss the potential for having a child with
sickle cell disease is considered primary prevention.
Rationale 4: Stating that neither has the disease, thus a child would not inherit the
disease, indicates no level of prevention.
Global Rationale: Primary prevention implies health and a high level of wellness for the
individual. Seeking out a genetics counselor is considered primary prevention. Indicating a need
for treatment would be considered secondary or tertiary prevention. Both individuals being
tested for carrier status would be considered secondary prevention, as it deals with early
diagnosis of health problems. Stating that neither has the disease, thus a child would not inherit
the disease, indicates no level of prevention.
Cognitive Level: Applying
Client Need: Health Promotion and Maintenance
Client Need Sub:
QSEN Competencies: III.A.1. Demonstrate knowledge of basic scientific methods
and processes.
AACN Essentials Competencies: I.1. Integrate theories and concepts from liberal
education into nursing practice.
NLN Competencies: Context and Environment: Health promotion/disease prevention.
Nursing/Integrated Concepts: Nursing Process: Evaluation
Learning Outcome: 3.2: Compare and contrast selected theories of wellness.
MNL Learning Outcome:
Page Number: p. 48
Question 3
Type: MCSA
The nurse is interviewing a client who has experienced a 15-pound weight gain during the
last year. The nurse obtains a 24-hour dietary recall, as well as determining the client’s
exercise habits and feelings regarding plans to take off the excess weight. Which type of
approach is the nurse using to enhance the client’s health?
1. Psychosocial perspective.

2. Illness perspective.
D’Amico/Barbarito Health & Physical Assessment in Nursing, 3/e
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3. Physiologic perspective.
4. Wellness perspective.
Correct Answer: 4
Rationale 1: A psychosocial perspective would not take into account the physiologic
alteration necessary for a successful weight loss program.
Rationale 2: An illness perspective does not include the positive attributes, such as
motivation, that the client possesses to address the 15-pound weight gain during the past year;
rather, it focuses on the illnesses, such as hypertension, that can result from the weight gain.
Rationale 3: A physiologic perspective could also be considered an illness perspective.
Rationale 4: When using a wellness perspective, the nurse focuses on the client’s personal
strengths and abilities to enhance health.
Global Rationale: When using a wellness perspective, the nurse focuses on the client’s
personal strengths and abilities to enhance health. An illness perspective does not include the
positive attributes that the client possesses to address the problem. A physiologic perspective
could also be considered an illness perspective. A psychosocial perspective would not take
into account the physiologic alteration necessary for a successful weight loss program.
Cognitive Level: Applying
Client Need: Health Promotion and Maintenance
Client Need Sub:
QSEN Competencies: III.A.1. Demonstrate knowledge of basic scientific methods
and processes.
AACN Essentials Competencies: I.1. Integrate theories and concepts from liberal
education into nursing practice.
NLN Competencies: Context and Environment: Health promotion/disease prevention.
Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 3.2: Compare and contrast selected theories of wellness.
MNL Learning Outcome:
Page Number: pp. 48–49
Question 4
Type: MCSA
The nurse is discharging a client who was hospitalized for a cerebral vascular accident
(CVA). The client will be cared for at home by family members. Which statement made by
the family indicates understanding of the client’s primary prevention needs after discharge?
1. “She will need instruction on using her walker.”
2. “She will need to have her flu shot this year.”
3. “She must take her blood pressure medications regularly.”
4. “She needs to have her cholesterol checked every 2 months.”
Correct Answer: 2
Rationale 1: Tertiary prevention involves strategies for rehabilitation; instructing the client
on proper use of a walker is an example of tertiary prevention.
Rationale 2: Having a flu shot is a primary prevention strategy.
Rationale 3: Taking blood pressure medication is secondary prevention since the treatment is
aimed at maintaining normal blood pressure and preventing complications from the condition.
Rationale 4: Having a cholesterol screening is an example of secondary prevention.

D’Amico/Barbarito Health & Physical Assessment in Nursing, 3/e
Copyright 2016 by Pearson Education, Inc.


Global Rationale: Having a flu shot is a primary prevention strategy. Taking blood pressure
medication is secondary prevention since the treatment is aimed at maintaining normal blood
pressure and preventing complications from the condition. Having a cholesterol screening is also
an example of secondary prevention. Tertiary prevention involves strategies for rehabilitation,
such as using a walker to aid ambulation.
Cognitive Level: Applying

Client Need: Physiological Integrity
Client Need Sub: Reduction of Risk Potential
QSEN Competencies: III.A.1. Demonstrate knowledge of basic scientific methods
and processes.
AACN Essentials Competencies: I.1. Integrate theories and concepts from
liberal education into nursing practice.
NLN Competencies: Context and Environment: Health promotion/disease prevention.
Nursing/Integrated Concepts: Nursing Process: Assessment
Learning Outcome: 3.2: Compare and contrast selected theories of wellness.
MNL Learning Outcome:
Page Number: pp. 48–49
Question 5
Type: MCMA
The nurse is planning a weight reduction class and wants to use the Health Belief Model
to motivate the clients in losing weight. Which are mediating factors in the Health Belief
Model? Standard Text: Select all that apply.
1. Likelihood of the individuals developing complications from being overweight.
2. The clients’ perception of the severity of an illness that could develop from being overweight.
3. The cost of the class that will be the client’s responsibility.
4. The amount of time commitment for the individuals taking the class.
5. The religion of the clients who will be taking the class.
Correct Answer: 1, 2, 3, 4
Rationale 1: Susceptibility refers to how likely an individual is to develop an illness or
condition and it is one of the mediating factors according to the Health Belief Model; the
likelihood of the individuals developing complications from being overweight is an example.
Rationale 2: The perceived severity of an illness is the second mediating factor that determines the
motivation to participating in health-promotion behaviors. The clients’ perception of the severity of
an illness that could develop from being overweight is an example.
Rationale 3: The actual cost of the class would be considered the physical cost of the
health-promoting activity versus continuing the unhealthy behavior. Physical and

psychologic perceived cost is the fourth mediating variable.
Rationale 4: Time commitment necessary for the class would be considered a psychologic
cost of the health promoting activity versus continuing the unhealthy behavior. Physical
and psychologic perceived cost is the fourth mediating variable.
Rationale 5: Religion is not identified as one of the mediating variable according to the Health
Belief Model.
Global Rationale: Mediating factors affect the health-promoting behaviors by influencing the
perception of susceptibility, severity, effectiveness, and cost (physical and psychologic).
Religion is not one of the identified mediating factors according to the Health Belief Model.
D’Amico/Barbarito Health & Physical Assessment in Nursing, 3/e
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Cognitive Level: Understanding
Client Need: Health Promotion and Maintenance
Client Need Sub:
QSEN Competencies: III.B.3. Base individualized care plan on patient values,
clinical expertise, and evidence.
AACN Essentials Competencies: I.1. Integrate theories and concepts from
liberal education into nursing practice.
NLN Competencies: Context and Environment: Health promotion/disease prevention.
Nursing/Integrated Concepts: Nursing Process: Planning
Learning Outcome: 3.3: Relate perspectives of health promotion to the individual, family, and
community.
MNL Learning Outcome:
Page Number: p. 49
Question 6
Type: MCSA
A staff nurse is participating on a committee examining ways to most effectively meet the goals
of Healthy People 2020. Which client would be the nurse’s highest priority based on the goals of

Healthy People 2020?
1. An adolescent female with her first pregnancy.
2. A diabetic client who maintains optimal visual intactness.
3. An IV drug abuser who converts to methadone use.
4. Several obese school-age children.
Correct Answer: 2
Rationale 1: A 16 year old with a pregnancy does not indicate healthy behavior across the
life span.
Rationale 2: The diabetic client maintaining visual intactness demonstrates the overall goal of
Healthy People 2020 through practicing healthy behavior in regards to controlling his diabetes
and improved long-term quality of life.
Rationale 3: An IV drug user still using a drug does not demonstrate healthy
behavior, nor improved quality of life or elimination of health inequities.
Rationale 4: Obesity levels in the school-aged population do not demonstrate
healthy behavior across the life span.
Global Rationale: The overriding goals for Healthy People 2020 are to eliminate preventable
diseases and health inequities, as well as promotion of healthy behavior across the entire life
span of an individual. The diabetic client maintaining visual intactness demonstrates healthy
behavior in regards to controlling his diabetes and improved long-term quality of life. A 16
year old with a pregnancy does not indicate healthy behavior across the life span. An IV drug
user still using a drug does not demonstrate healthy behavior, nor improved quality of life or
elimination of health inequities. Obesity levels in the school-aged population do not
demonstrate healthy behavior across the life span.
Cognitive Level: Applying
Client Need: Health Promotion and Maintenance
Client Need Sub:
QSEN Competencies: III.B.3. Base individualized care plan on patient values,
clinical expertise, and evidence.
D’Amico/Barbarito Health & Physical Assessment in Nursing, 3/e
Copyright 2016 by Pearson Education, Inc.

AACN Essentials Competencies: VII.11. Participate in clinical prevention and
population-focused interventions with attention to effectiveness, efficiency, costeffectiveness, and equity. NLN Competencies: Context and Environment: Apply health
promotion/disease prevention strategies; Apply health policy.
Nursing/Integrated Concepts: Nursing Process: Implementation
Learning Outcome: 3.4: Apply the goals and objectives for each topic area in Healthy People
2020 to nursing practice.
MNL Learning Outcome:
Page Number: pp. 54–66
Question 7
Type: MCMA
The nurse is planning an exercise class for a group of young adults. When promoting the benefits
of regular exercise, which topics will the nurse include? Standard Text: Select all that apply.
1. Reducing risk of cardiovascular disease.
2. Reducing risk of skin cancer.
3. Reducing risk of colon cancer.
4. Reducing risk of renal disease.
5. Reduced risk of hypertension.
Correct Answer: 1, 3, 5
Rationale 1: Regular physical activity has been found to decrease the risk of developing
or dying from cardiovascular disease.
Rationale 2: The development of skin cancer is not related to physical activity.
Rationale 3: Regular physical activity has been found to decrease the risk of developing
or dying from colon cancer.
Rationale 4: The development of renal disease is not related to physical activity.
Rationale 5: Regular physical activity has been found to decrease the risk of
developing or dying from hypertension.
Global Rationale: According to Healthy People 2020, regular physical activity results in
a decreased risk of cardiovascular disease, colon cancer, and hypertension. It does not

result in decreasing the risk of skin cancer or renal disease.
Cognitive Level: Remembering
Client Need: Health Promotion and Maintenance
Client Need Sub:
QSEN Competencies: III.B.3. Base individualized care plan on patient values,
clinical expertise, and evidence.
AACN Essentials Competencies: VII.11. Participate in clinical prevention and
population-focused interventions with attention to effectiveness, efficiency, costeffectiveness, and equity. NLN Competencies: Context and Environment: Apply health
promotion/disease prevention strategies; Apply health policy.
Nursing/Integrated Concepts: Nursing Process: Assessment
Learning Outcome: 3.4: Apply the goals and objectives for each topic area in Healthy People
2020 to nursing practice.
MNL Learning Outcome:
Page Number: pp. 54–66
D’Amico/Barbarito Health & Physical Assessment in Nursing, 3/e
Copyright 2016 by Pearson Education, Inc.


Question 8
Type: MCSA
The school nurse is working with several adolescents during gym class. Which adolescent is
meeting the age-appropriate recommendations for physical activity developed by the
Centers for Disease Control (CDC)?
1. A 17 year old who runs at a fast pace for 30 minutes five times per week and practices yoga
for 30 minutes two times per week.
2. A 16 year old who swims for 60 minutes 5 times per week and jogs for 60 minutes the other
2 days per week.
3. A 15 year old who lifts moderately heavy weights 15 minutes three times per week.
4. A 13 year old who speed-walks 60 minutes five times per week.
Correct Answer: 2

Rationale 1: Running for 30 minutes five times per week and practicing yoga for 30
minutes two times per week does not meet the CDC recommendation of 1 hour of moderate
to vigorous exercise daily for children and adolescents ages 6 to 17.
Rationale 2: Swimming for 60 minutes five times per week and jogging for 60 minutes the
remaining 2 days per week meets the CDC recommendation of 1 hour of moderate to
vigorous exercise daily for children and adolescents ages 6 to 17.
Rationale 3: Lifting weights for 15 minutes three times per week does not meet the
CDC recommendation of 1 hour of moderate to vigorous exercise daily for children and
adolescents ages 6 to 17.
Rationale 4: Speed walking for 60 minutes five times per week does not meet the
CDC recommendation of 1 hour of moderate to vigorous exercise daily for children
and adolescents ages 6 to 17.
Global Rationale: The CDC recommendation for physical activity for children and adolescents,
ages 6 to 17, are: 1 hour or more of physical activity every day with most of the hour consisting of
moderate- or vigorous-intensity aerobic activity. The CDC also recommends that during the daily
hour of physical activity, muscle- and bone-strengthening activity should each be included at least
3 days per week. Therefore, the 16 year old who swims for 1 hour 5 days per week and jogs for 60
minutes the remaining 2 days per week meets the CDC recommendations. The swimming would
also be considered a muscle-strengthening activity and the jogging would be considered a bonestrengthening activity. The other options do not meet CDC recommendations.
Cognitive Level: Applying
Client Need: Health Promotion and Maintenance
Client Need Sub:
QSEN Competencies: III.B.3. Base individualized care plan on patient values,
clinical expertise, and evidence.
AACN Essentials Competencies: VII.11. Participate in clinical prevention and
population-focused interventions with attention to effectiveness, efficiency, costeffectiveness, and equity. NLN Competencies: Context and Environment: Apply health
promotion/disease prevention strategies; Apply health policy.
Nursing/Integrated Concepts: Nursing Process: Implementation
Learning Outcome: 3.4: Apply the goals and objectives for each topic area in Healthy People
2020 to nursing practice.

MNL Learning Outcome:
D’Amico/Barbarito Health & Physical Assessment in Nursing, 3/e
Copyright 2016 by Pearson Education, Inc.


Page Number: pp. 54–66
Question 9
Type: MCSA
The school nurse is working with several school-aged children in health class. Which child
is meeting age-appropriate recommendations for physical activity developed by the Centers
for Disease Control (CDC)?
1. A 12-year-old who plays soccer 4 days per week at the neighborhood playground and 3
days per week for a soccer team.
2. A 10-year-old who runs wind sprints for 15 minutes for PE class 1 day per week.
3. An 8-year-old who plays on the monkey bars at both 30-minute recess periods three times
per week.
4. A 9-year-old who plays kickball at one 20-minute recess daily five times per week and
plays basketball for a team 2 days per week.
Correct Answer: 1
Rationale 1: The 12-year-old who plays soccer 4 days per week at the neighborhood playground
and 3 days per week for a soccer team is meeting the recommended 60 minutes per day of
moderate- to vigorous-intensity aerobic activity.
Rationale 2: The 10-year-old who runs wind sprints for 15 minutes for PE class 1 day per week
is not meeting the recommended 60 minutes per day of moderate- to vigorous-intensity aerobic
activity.
Rationale 3: The 8-year-old who plays on the monkey bars at both 30-minute recess
periods three times per week is not meeting the recommended 60 minutes per day of
moderate- to vigorous-intensity aerobic activity.
Rationale 4: The 9-year-old who plays kickball at one 20-minute recess daily five times
per week and plays basketball for a team 2 days per week is not meeting the recommended

60 minutes per day of moderate- to vigorous-intensity aerobic activity.
Global Rationale: The CDC recommendation for physical activity for children and adolescents,
ages 6 to 17, are: 1 hour or more of physical activity every day with most of the hour consisting of
moderate- or vigorous-intensity aerobic activity. The CDC also recommends that during the daily
hour of physical activity, muscle- and bone-strengthening activity should each be included at least
3 days per week. Only the child who plays soccer each day meets the recommended activity levels
for age. The 10-year-old is exercising only 15 minutes once per week. The 8-year-old is exercising 60
minutes per day, but only three times per week, which does not meet the criteria for 60 minutes of
daily exercise. The 9-year-old is only exercising for 20 minutes 5 days while playing kickball and 2
days of basketball, which does not meet the minimum criteria.
Cognitive Level: Applying
Client Need: Health Promotion and Maintenance
Client Need Sub:
QSEN Competencies: III.B.3. Base individualized care plan on patient values,
clinical expertise, and evidence.
AACN Essentials Competencies: VII.11. Participate in clinical prevention and
population-focused interventions with attention to effectiveness, efficiency, costeffectiveness, and equity. NLN Competencies: Context and Environment: Apply health
promotion/disease prevention strategies; Apply health policy.
Nursing/Integrated Concepts: Nursing Process: Implementation
D’Amico/Barbarito Health & Physical Assessment in Nursing, 3/e
Copyright 2016 by Pearson Education, Inc.


Learning Outcome: 3.4: Apply the goals and objectives for each topic area in Healthy People
2020 to nursing practice.
MNL Learning Outcome:
Page Number: pp.54–66
Question 10
Type: MCSA
A nurse teaching a smoking cessation class includes the following statements in the

presentation: “Everyone here tonight has the ability to control the urge to smoke. You are all
rational people who understand that smoking is the cause of many significant health problems,
and that it is a voluntary event that you are going to learn to do without. Regardless of your
motivation, you will get help here to understand your triggers to smoke, and how to control
them.” Which theory or model is the nurse using to promote smoking cessation?
1. The Self-Efficacy Model.
2. The Theory of Reasoned Action.
3. The Health Promotion Model.
4. The Health Belief
Model. Correct Answer: 2
Rationale 1: Self-efficacy is part of the Health Belief Model, and not its own theory. Selfefficacy refers to how confident individuals are in their own ability to perform a behavior.
Rationale 2: The Theory of Reasoned Action/Planned Behavior is a prediction theory based on
the assumptions that behavior is under volitional control and that people are rational beings. The
theory also suggests that individuals are more likely to participate in healthy behaviors if they
believe the benefit outweighs the cost of the behavior. The statement by the nurse indicates
these principles.
Rationale 3: The Health Promotion Model depicts people as multidimensional in interactions
with their environments, and focuses on variables that impact behavior. Variables that impact
behavior include personal factors such as age, strength, and agility; cognitive factors such as an
individual’s perceived benefit of a health promoting action; and intrapersonal influences such
as the influence of family members, friends, or a health care provider. The statement by the
nurse does not depict this model.
Rationale 4: The Health Belief Model relates to cues to action for a change in behavior. The
cues to action in this model refer to internal and external stimuli that motivate a person to
participate in health promoting behavior. An example of a cue to action is a female getting
yearly mammograms due to a family member having breast cancer. The statement by the
nurse does not depict this model.
Global Rationale: The Theory of Reasoned Action/Planned Behavior is a prediction theory based
on the assumptions that behavior is under volitional control and that people are rational beings. The
theory also suggests that individuals are more likely to participate in healthy behaviors if they

believe the benefit outweighs the cost of the behavior. Self-efficacy refers to how confident
individuals are in their own ability to perform a behavior, and is part of the Health Belief Model,
not its own theory. The Health Promotion Model depicts people as multidimensional in interactions
with their environments, and focuses on variables that impact behavior. Variables that impact
behavior include personal factors such as age, strength, and agility; cognitive factors such as an
individual’s perceived benefit of a health-promoting action; and intrapersonal influences such as
the influence of family members, friends, or a health care
D’Amico/Barbarito Health & Physical Assessment in Nursing, 3/e
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provider. The Health Belief Model relates to cues to action. The cues to action in this model
refer to internal and external stimuli that motivate a person to participate in health-promoting
behavior. An example of a cue to action is a female getting yearly mammograms due to a
family member having breast cancer.
Cognitive Level: Applying
Client Need: Health Promotion and Maintenance
Client Need Sub:
QSEN Competencies: III.B.3. Base individualized care plan on patient values,
clinical expertise, and evidence.
AACN Essentials Competencies: I.1. Integrate theories and concepts from
liberal education into nursing practice.
NLN Competencies: Context and Environment: Health promotion/disease
prevention. Nursing/Integrated Concepts: Nursing Process: Implementation
Learning Outcome: 3.3: Relate perspectives of health promotion to the individual, family, and
community.
MNL Learning Outcome:
Page Number: pp. 48–54
Question 11
Type: MCSA

The nurse is working with several clients in a fitness setting. Which client is meeting the ageappropriate recommendations for physical activity developed by the Centers for Disease
Control (CDC)?
1. A 37-year-old who lifts weights for one hour twice per week.
2. A 42-year-old who walks at a slow pace for 60 minutes 4 days per week.
3. A 45-year-old who walks briskly for 30 minutes 6 days per week.
4. A 57-year-old who swims for 20 minutes twice per week.
Correct Answer: 3
Rationale 1: The weight lifter is not exercising the minimum number of hours per week of
the recommended moderate-intensity physical activities, for at least 2 hours and 30 minutes
per week or 1 hour and 15 minutes of vigorous-intensity aerobic physical activity per week;
or an equivalent combination of moderate- and vigorous-intensity aerobic activity.
Rationale 2: The 42-year-old who is walking at a slow pace is not meeting the
minimum criteria for moderate exercise.
Rationale 3: The adult who walks briskly for 30 minutes 6 days per week is meeting the criteria
of moderate-intensity physical activities for at least 2 hours and 30 minutes per week or 1 hour
and 15 minutes of vigorous-intensity aerobic physical activity per week; or an equivalent
combination of moderate- and vigorous-intensity aerobic activity, as well as the suggested
aerobic activity occurring for at least 10 minute episodes throughout the week.
Rationale 4: The swimmer is only exercising twice per week for a total of 40 minutes, which
does not meet the minimum requirements for moderate physical activity.
Global Rationale: The recommendations for physical activity for adults are: moderate-intensity
physical activities for at least 2 hours and 30 minutes per week or 1 hour and 15 minutes of
vigorous-intensity aerobic physical activity per week, or an equivalent combination of moderate-and
vigorous-intensity aerobic activity. Aerobic activity should occur for at least 10-minute episodes
throughout the week. Only the adult who walks briskly is meeting the criteria of
D’Amico/Barbarito Health & Physical Assessment in Nursing, 3/e
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moderate-intensity physical activities for at least 2 hours and 30 minutes per week or 1 hour and

15 minutes of vigorous-intensity aerobic physical activity per week, or an equivalent
combination of moderate- and vigorous-intensity aerobic activity. The weight lifter is not
exercising the minimum number of hours per week. The 42-year-old who is walking at a slow
pace is not meeting the minimum criteria for moderate exercise. The swimmer is only
exercising twice per week for a total of 40 minutes.
Cognitive Level: Applying
Client Need: Health Promotion and Maintenance
Client Need Sub:
QSEN Competencies: III.B.3. Base individualized care plan on patient values,
clinical expertise, and evidence.
AACN Essentials Competencies: VII.11. Participate in clinical prevention and
population-focused interventions with attention to effectiveness, efficiency, costeffectiveness, and equity. NLN Competencies: Context and Environment: Apply health
promotion/disease prevention strategies; Apply health policy.
Nursing/Integrated Concepts: Nursing Process: Implementation
Learning Outcome: 3.4: Apply the goals and objectives for each topic area in Healthy People
2020 to nursing practice.
MNL Learning Outcome:
Page Number: pp. 54–66
Question 12
Type: MCSA
The nurse is working with a 60-year-old female client in a fitness setting. Which is the
correct maximum desired heart rate target zone for both moderate- and vigorous-intensity
workouts for this client?
1. 66–80, and 112–124.
2. 60–85, and 85–110.
3. 80–110, and 120–130.
4. 80–112, and 112–136.
Correct Answer: 4
Rationale 1: Utilizing the proper calculation method, 66–80, and 112–124 beats per minute are
not the desired heart rate target zones for moderate- and vigorous-intensity workouts for a 60

year old.
Rationale 2: Utilizing the proper calculation method, 60–85, and 85–110 beats per minute are
not the desired heart rate target zones for moderate- and vigorous-intensity workouts for a 60
year old.
Rationale 3: Utilizing the proper calculation method, 80–110, and 120–130 beats per minute are
not the desired heart rate target zones for moderate- and vigorous-intensity workouts for a 60
year old.
Rationale 4: Utilizing the proper calculation method, 80–112, and 112–136 beats per minute are
the desired heart rate target zones for moderate- and vigorous-intensity workouts for a 60 year
old.
Global Rationale: Moderate intensity exercise should raise the heart rate 50–70%. Vigorous
intensity exercise should raise the heart rate 70–85%. To calculate the minimum and maximum
targets zones from each type of activity, you must first determine the maximum heart rate. This

D’Amico/Barbarito Health & Physical Assessment in Nursing, 3/e
Copyright 2016 by Pearson Education, Inc.


is done by subtracting the individual’s age from 220. Therefore, 220 – 60 = 160. 160 × 0.5
(50%) = 80; 160 × 0.7 (70%) = 112. For vigorous activity, 160 × 0.7 = 112; 160 × 0.85 (85%) =
136. Therefore, 80–112, and 112–136 is the correct
answer. Cognitive Level: Applying
Client Need: Health Promotion and Maintenance
Client Need Sub:
QSEN Competencies: III.B.3. Base individualized care plan on patient values,
clinical expertise, and evidence.
AACN Essentials Competencies: VII.11. Participate in clinical prevention and
population-focused interventions with attention to effectiveness, efficiency, costeffectiveness, and equity. NLN Competencies: Context and Environment: Apply health
promotion/disease prevention strategies; Apply health policy.
Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 3.4: Apply the goals and objectives for each topic area in Healthy People
2020 to nursing practice.
MNL Learning Outcome:
Page Number: pp. 54–66

Question 13
Type: MCMA
The client inquires about isotonic exercises that will increase muscle tone. Which activities
will the nurse recommend to the client?
Standard Text: Select all that apply.
1. Running.
2. Weight lifting.
3. Walking.
4. Pushing against a wall.
5. Cycling.
Correct Answer: 1, 3, 5
Rationale 1: Running is an example of isotonic exercise which increases muscle tone.
Rationale 2: Resistive exercises do not increase muscle tone. An example of resistive
exercise includes weight lifting.
Rationale 3: Walking is an example of isotonic exercise which increases muscle tone.
Rationale 4: Isometric exercises include those that affect muscle tension but do not result in
muscle or joint movement. Isometric exercises are useful for strengthening abdominal,
gluteal, and quadriceps muscles, for maintaining strength of immobilized muscles, and for
endurance training. Examples of isometric exercise would include tensing of thigh muscles
and extending the arms and pushing against a wall.
Rationale 5: Cycling is an example of isotonic exercise which increases muscle tone. Global
Rationale: Isotonic exercises increase tone, and involve activities such as running, walking, and
cycling. Resistive exercises such as weight lifting do not increase muscle tone. Isometric
exercises include those that affect muscle tension but do not result in muscle or joint movement.
Isometric exercises are useful for strengthening abdominal, gluteal, and quadriceps

muscles, for maintaining strength of immobilized muscles, and for endurance training. Examples
of isometric exercise would include tensing of thigh muscles and extending the arms and
pushing against a wall. Cycling is an example of isotonic exercise which increases muscle tone.
D’Amico/Barbarito Health & Physical Assessment in Nursing, 3/e
Copyright 2016 by Pearson Education, Inc.


Cognitive Level: Applying
Client Need: Health Promotion and Maintenance
Client Need Sub:
QSEN Competencies: III.B.3. Base individualized care plan on patient values,
clinical expertise, and evidence.
AACN Essentials Competencies: VII.11. Participate in clinical prevention and
population-focused interventions with attention to effectiveness, efficiency, costeffectiveness, and equity. NLN Competencies: Context and Environment: Apply health
promotion/disease prevention strategies; Apply health policy.
Nursing/Integrated Concepts: Nursing Process: Implementation
Learning Outcome: 3.4: Apply the goals and objectives for each topic area in Healthy People
2020 to nursing practice.
MNL Learning Outcome:
Page Number: pp. 63–64
Question 14
Type: MCSA
The nurse is preparing a seminar presentation regarding causes of death in the United
States. Which cause of death with the nurse include as being responsible for more deaths in
the United States than all of the others combined?
1. HIV and AIDS.
2. Cigarette smoking.
3. Automobile crashes.
4. Drug abuse.
Correct Answer: 2

Rationale 1: HIV and AIDS are not responsible for the most deaths in the United States.
Rationale 2: Cigarette smoking is responsible for more deaths in the United States than death
from HIV/AIDS, drug abuse, homicide, suicide, automobile crashes, and fire combined.
Rationale 3: Automobile crashes are not responsible for the most deaths in the United States.
Rationale 4: Drug abuse is not responsible for the most deaths in the United States.
Global Rationale: Cigarette smoking is responsible for more deaths in the United States than
death from HIV/AIDS, drug abuse, homicide, suicide, automobile crashes, and fire combined.
Smoking is a risk factor for heart disease, breathing disorders, and lung cancer. Secondary
smoke increases the incidence of asthma and bronchitis in children, and heart and lung
diseases in adults.
Cognitive Level: Remembering
Client Need: Health Promotion and Maintenance
Client Need Sub:
QSEN Competencies: III.B.3. Base individualized care plan on patient values,
clinical expertise, and evidence.
AACN Essentials Competencies: VII.11. Participate in clinical prevention and
population-focused interventions with attention to effectiveness, efficiency, costeffectiveness, and equity. NLN Competencies: Context and Environment: Apply health
promotion/disease prevention strategies; Apply health policy.
Nursing/Integrated Concepts: Nursing Process: Assessment

D’Amico/Barbarito Health & Physical Assessment in Nursing, 3/e
Copyright 2016 by Pearson Education, Inc.


Learning Outcome: 3.4: Apply the goals and objectives for each topic area in Healthy People
2020 to nursing practice.
MNL Learning Outcome:
Page Number: pp. 54–66
Question 15
Type: MCSA

A nursing student is preparing an educational program concerning breast cancer. The
focus of the program is secondary prevention. Which topic would be most appropriate?
1. A dietary discussion concerning the connection between breast cancer and dietary intake.
2. Techniques for performing self-breast examination.
3. Radical mastectomy.
4. Chemotherapy and radiation treatments.
Correct Answer: 2
Rationale 1: Primary prevention implies that an individual is healthy and focuses on
health promotion and disease prevention. Primary prevention is demonstrated by the
discussion of dietary recommendations for prevention of breast cancer.
Rationale 2: Secondary prevention emphasizes early diagnosis and treatment of health
problems, and includes screenings such as teaching clients about self-breast examination.
Rationale 3: Tertiary prevention is aimed toward treatment of a condition and restoration
of health to the highest level of wellness possible. Treatment options for breast cancer, such
as a radical mastectomy, would be considered a form of tertiary prevention.
Rationale 4: Tertiary prevention is aimed toward treatment of a condition and restoration
of health to the highest level of wellness possible. Treatment options for breast cancer, such
as chemotherapy and radiation, would be considered a form of tertiary prevention.
Global Rationale: Secondary prevention emphasizes early diagnosis and treatment of health
problems, and includes screenings such as teaching clients about self-breast examination and
mammography. Primary prevention has a focus geared toward health promotion and disease
prevention, which is demonstrated by the discussion of dietary recommendations. Tertiary
prevention is aimed toward treatment of a condition and restoration of health to the highest level
of wellness possible. Treatment options for breast cancer such as a radical mastectomy,
chemotherapy, and radiation would be considered forms of tertiary prevention.
Cognitive Level: Applying
Client Need: Health Promotion and Maintenance
Client Need Sub:
QSEN Competencies: III.A.1. Demonstrate knowledge of basic scientific methods
and processes.

AACN Essentials Competencies: I.1. Integrate theories and concepts from
liberal education into nursing practice.
NLN Competencies: Context and Environment: Health promotion/disease prevention.
Nursing/Integrated Concepts: Nursing Process: Planning
Learning Outcome: 3.2: Compare and contrast selected theories of wellness.
MNL Learning Outcome:
Page Number: p. 48
Question 16
D’Amico/Barbarito Health & Physical Assessment in Nursing, 3/e
Copyright 2016 by Pearson Education, Inc.


Type: MCSA
During a routine health examination, a client reports concern about her potential for the
development of heart disease. During the assessment, the nurse reviews the client’s risk factors.

Which of the client’s risk factors are considered modifiable?
1. Age, heredity, and weight.
2. Family history, self-history of diabetes mellitus type 1, and age
3. Weight, dietary intake, and environmental risks.
4. Biological characteristics, lifestyle factors, and family history.
Correct Answer: 3
Rationale 1: Age and heredity are non-modifiable risk factors (cannot be changed by the
client’s actions); while weight is a modifiable risk factor (can be changed by the client’s
actions). Rationale 2: Family history, self-history of diabetes mellitus type 1, and age are
all non-modifiable risk factors (cannot be changed by the client’s actions).
Rationale 3: Weight, dietary intake, and environmental risks are all modifiable risk factor (can
be changed by the client’s actions).
Rationale 4: Biological characteristics and family history are non-modifiable risk factors
(cannot be changed by the client’s actions); while lifestyle factors are modifiable risk factors

(can be changed by the client’s actions).
Global Rationale: Risk factors that can be controlled by client action are termed modifiable.
Those risk factors which cannot be changed by the client, such as age, heredity, genetic
factors, certain health conditions, and biological characteristics, are called non-modifiable
factors. Cognitive Level: Applying
Client Need: Physiological Integrity
Client Need Sub: Reduction of Risk Potential
QSEN Competencies: III.B.3. Base individualized care plan on patient values,
clinical expertise, and evidence.
AACN Essentials Competencies: I.1. Integrate theories and concepts from liberal
education into nursing practice.
NLN Competencies: Context and Environment: Health promotion/disease prevention.
Nursing/Integrated Concepts: Nursing Process: Assessment
Learning Outcome: 3.3: Relate perspectives of health promotion to the individual, family,
and community.
MNL Learning Outcome:
Page Number: p. 66
Question 17
Type: MCSA
The Health Promotion Model is being used by a nurse to analyze the potential impact of the
importance of regular exercise. According to the model, which participant is most likely to
initiate and consistently participate in a successful program of exercise after attending the
session?
1. An overweight female who has never participated in an exercise program.
2. A 30-year-old male who admits frequently joining and quitting exercise groups.
3. A teenaged male who has low self-esteem.
4. A 24-year-old female who reports she is anxious to begin exercising with her husband.
Correct Answer: 4
D’Amico/Barbarito Health & Physical Assessment in Nursing, 3/e
Copyright 2016 by Pearson Education, Inc.

Rationale 1: The overweight female who has never participated in an exercise program would
most likely have less motivation to initiate and consistently participate in a successful exercise
program than the 24-year-old female who is anxious to begin exercise with her husband, who
would be a source of support, according to the Health Promotion Model. Rationale 2: A 30year-old male who frequently joins and quits exercise groups is less likely to initiate and
consistently participate in a successful exercise program than the 24-year-old female who is
anxious to begin exercise with her husband, who would be a source of support, according to the
Health Promotion Model.
Rationale 3: A teenaged male with low self-esteem is less likely to initiate and consistently
participate in a successful exercise program than the 24-year-old female who is anxious to
begin exercise with her husband, who would be a source of support, according to the Health
Promotion Model.
Rationale 4: The 24-year-old female who reports she is anxious to begin exercising with her
husband displays the motivational characteristics of the Health Promotion Model to most
likely initiate and consistently participate in a successful exercise program.
Global Rationale: The Health Promotion Model views persons as “multidimensional and in
interaction with interpersonal and physical environments as they pursue health.” The model
can be used to make inferences about people’s motivational and behavioral outcomes. The
female who has a strong motivation and social support demonstrates the strongest likelihood of
following through with the program. Variables such as low self-esteem, prior negative
outcomes, and a lack of experience can reduce the individual’s willingness to engage in the
health-promoting activities.
Cognitive Level: Analyzing
Client Need: Psychosocial Integrity
Client Need Sub:
QSEN Competencies: III.B.3. Base individualized care plan on patient values,
clinical expertise, and evidence.
AACN Essentials Competencies: VII.5. Use evidence-based practices to guide health
teaching, health counseling, screening, outreach, disease and outbreak investigation,

referral, and follow-up throughout the lifespan.
NLN Competencies: Context and Environment: Apply health promotion/disease
prevention strategies; Apply health policy.
Nursing/Integrated Concepts: Nursing Process: Evaluation
Learning Outcome: 3.5: Demonstrate how to use the nursing process to encourage
health promotion.
MNL Learning Outcome:
Page Number: pp. 66–67
Question 18
Type: MCMA
The nurse is planning a presentation to a group of middle-school students regarding health
promotion and wellness. Which concepts will the nurse plan to include in the
presentation? Standard Text: Select all that apply.
1. Individuals are more knowledgeable in today’s society in regard to health care issues.
2. Consumers of health care in today’s society demonstrate less decision-making
capabilities concerning their health care than in the past.
D’Amico/Barbarito Health & Physical Assessment in Nursing, 3/e
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3. The focus of Healthy People 2020 is on the early treatment of disease and
pathologic conditions.
4. The roles of health care providers in today’s society have expanded.
5. Individuals, in general, are proactive regarding health care practices and desire care
that promotes health and prevents disease.
Correct Answer: 1, 4, 5
Rationale 1: Individuals in today’s society are more knowledgeable regarding health care
issues than in the past.
Rationale 2: Clients are actively involved in the decision-making process related to their
health care.

Rationale 3: The focus of Healthy People 2020 is on health promotion and disease prevention
rather than early treatment of disease and pathologic conditions.
Rationale 4: Due to the complexity of the health care system of today, the role of health
care providers has changed and expanded.
Rationale 5: Individuals in today’s society are proactive in regard to their health care needs
and an emphasis is placed on health promotion and disease prevention.
Global Rationale: Individuals in today’s society are more knowledgeable in regard to health
care issues; thus, individuals demonstrate control in decision-making capabilities concerning
their health care. Healthy People 2020 focuses on health and wellness, rather than early
treatment of disease and pathologic conditions. Due to the complexity of today’s health care
system, the role of health care providers has changed and expanded. Lastly, individuals are
more proactive in regard to health care practices of today and desire care that emphasizes health
promotion.
Cognitive Level: Remembering
Client Need: Health Promotion and Maintenance
Client Need Sub:
QSEN Competencies: III.A.1. Demonstrate knowledge of basic scientific methods
and processes.
AACN Essentials Competencies: I.1. Integrate theories and concepts from liberal
education into nursing practice.
NLN Competencies: Context and Environment: Health promotion/disease prevention.
Nursing/Integrated Concepts: Nursing Process: Planning
Learning Outcome: 3.1: Distinguish between concepts of wellness and health promotion.
MNL Learning Outcome:
Page Number: pp. 48–49
Question 19
Type: MCSA
A client who has recently experienced a fracture is concerned about maintaining muscle strength
during recuperation. Which type of exercise will the nurse recommend for this client?
1. Isometric exercise.

2. Isotonic exercise.
3. Resistive exercise.
4. Anaerobic exercise.
Correct Answer: 1

D’Amico/Barbarito Health & Physical Assessment in Nursing, 3/e
Copyright 2016 by Pearson Education, Inc.


Rationale 1: Isometric exercises affect muscle tension. Joint movement does not occur during
isometric exercises. This type of exercise can be used for strength maintenance for immobilized
clients and can be achieved with tensing the muscles in the affected arm or extending the arm.
Rationale 2: Isotonic exercises increase tone and involve activities such as running, walking,
and cycling. These types of activities may be contraindicated by clients having a fracture.
Rationale 3: Resistive exercises use resistance. An example of resistive exercise includes
weight lifting. This activity may be contraindicated by a client with a fracture.
Rationale 4: Anaerobic exercises are activities used to promote endurance training by
participating in short periods of vigorous activity. This type of activity would not be indicated
for a client with a fracture.
Global Rationale: Isometric exercises affect muscle tension. Joint movement does not
occur during isometric exercises. Examples of isometric exercise would include tensing of
thigh muscles, extending the arms, and pushing against a wall. For this client, the best
isometric exercise would be tensing the muscles in the affected arm or extending the arm.
This type of exercise can be used for strength maintenance for immobilized clients. Isotonic
exercises increase tone and involve activities such as running, walking, and cycling. These
types of activities may be contraindicated by clients having a fracture. Resistive exercises
use resistance. An example of resistive exercise includes weight lifting. Anaerobic exercises
are activities used to promote endurance.
Cognitive Level: Applying
Client Need: Physiological Integrity Client

Need Sub: Physiological Adaptation
QSEN Competencies: III.B.3. Base individualized care plan on patient values,
clinical expertise, and evidence.
AACN Essentials Competencies: VII.5. Use evidence-based practices to guide health
teaching, health counseling, screening, outreach, disease and outbreak investigation,
referral, and follow-up throughout the lifespan.
NLN Competencies: Context and Environment: Apply health
promotion/disease prevention strategies; Apply health policy.
Nursing/Integrated Concepts: Nursing Process: Planning
Learning Outcome: 3.5: Demonstrate how to use the nursing process to encourage
health promotion.
MNL Learning Outcome:
Page Number: pp. 63–64
Question 20
Type: MCMA
The client who reports having difficulty sleeping at night asks the nurse for suggestions to
enhance getting a good night’s sleep. Which recommendations may be beneficial to this client?
Standard Text: Select all that apply.
1. Performing 30 minutes of exercise prior to going bedtime.
2. Setting a regular bedtime.
3. Establishing a relaxation routine at bedtime.
4. Avoiding alcohol.
5. Watching television to assist in falling asleep.
Correct Answer: 2, 3, 4
D’Amico/Barbarito Health & Physical Assessment in Nursing, 3/e
Copyright 2016 by Pearson Education, Inc.


Rationale 1: Performing exercises 30 minutes prior to going to bed will most likely stimulate
the individual rather than promote sleep.

Rationale 2: Setting a regular bedtime, as well as a regular waking time, promotes a more
restful sleep.
Rationale 3: A relaxation routine prior to bedtime promotes sleep.
Rationale 4: Avoiding alcohol will promote restful sleep since alcohol interferes with a normal
sleep pattern.
Rationale 5: Watching television prior to attempting to fall asleep will most likely
stimulate the individual rather than promote sleep.
Global Rationale: Establishing a routine including a regular bedtime and relaxation promote a
restful sleep. Alcohol may be associated with altered sleep patterns. Performing exercises prior to
going to bed and watching television will stimulate the individual rather than promote sleep.
Cognitive Level: Applying
Client Need: Physiological Integrity
Client Need Sub: Basic Care and Comfort
QSEN Competencies: III.B.3. Base individualized care plan on patient values,
clinical expertise, and evidence.
AACN Essentials Competencies: VII.5. Use evidence-based practices to guide health
teaching, health counseling, screening, outreach, disease and outbreak investigation,
referral, and follow-up throughout the lifespan.
NLN Competencies: Context and Environment: Apply health
promotion/disease prevention strategies; Apply health policy.
Nursing/Integrated Concepts: Nursing Process: Implementation
Learning Outcome: 3.5: Demonstrate how to use the nursing process to encourage
health promotion.
MNL Learning Outcome:
Page Number: pp. 64–65
Question 21
Type: MCSA
During a routine pediatric health maintenance appointment, the parents of a newborn report
being concerned their baby is sleeping too much. The nursing assessment reveals the newborn
sleeps 16 hours each day. Which response by the nurse is the most appropriate?

1. “The recommendation for a newborn is 16 to 18 hours of sleep per day.”
2. “Your newborn is sleeping too much.”
3. “Do not allow your newborn to nap as often.”
4. “I would recommend putting your baby to sleep later in the evening.”
Correct Answer: 1
Rationale 1: Sleeping 16 to 18 hours per day is recommended for newborns. This child is
receiving the recommended amount of sleep for age per day.
Rationale 2: The nurse’s response is incorrect since 16 hours of sleep per day is within
the recommendation for sleep per day for a newborn.
Rationale 3: Newborns require 16 to 18 hours of sleep per day. Napping is
recommended throughout the day to achieve this total amount of sleep in a day.
Rationale 4: Newborns require 16 to 18 hours of sleep per day. There is no reason to change
the current sleep schedule for this client.
D’Amico/Barbarito Health & Physical Assessment in Nursing, 3/e
Copyright 2016 by Pearson Education, Inc.


Global Rationale: Sleeping 16 to 18 hours per day is recommended for newborns. This child
is receiving the recommended amount of sleep for age per day. There is no need to
discourage napping or to recommend putting the baby to sleep later in the evening.
Cognitive Level: Understanding
Client Need: Health Promotion and Maintenance
Client Need Sub:
QSEN Competencies: III.B.3. Base individualized care plan on patient values,
clinical expertise, and evidence.
AACN Essentials Competencies: VII.11. Participate in clinical prevention and
population-focused interventions with attention to effectiveness, efficiency, costeffectiveness, and equity. NLN Competencies: Context and Environment: Apply health
promotion/disease prevention strategies; Apply health policy.
Nursing/Integrated Concepts: Nursing Process: Implementation
Learning Outcome: 3.4: Apply the goals and objectives for each topic area in Healthy People

2020 to nursing practice.
MNL Learning Outcome:
Page Number: p. 65
Question 22
Type: MCSA
The parents of a 7-month-old infant, being seen at the clinic for the administration of a
hepatitis B vaccine, ask if their baby can also be given a vaccine to prevent the
chickenpox during this visit. Which response by the nurse is the most appropriate?
1. “It will be less stressful to administer both shots during this visit.”
2. “The additional injection will make your child run a fever.”
3. “You really should wait and come back next month for this immunization.”
4. “This immunization is not offered until after the age of 12 months.”
Correct Answer: 4
Rationale 1: This response by the nurse is incorrect since the first dose of varicella
vaccine cannot be given until 12 to 15 months of age.
Rationale 2: This response by the nurse is incorrect since the first dose of varicella
vaccine cannot be given until 12 to 15 months of age.
Rationale 3: The child will only be 8 months old if returning to the office in 1 month; therefore,
this response by the nurse is incorrect since the first dose of varicella vaccine cannot be given
until 12 to 15 months of age.
Rationale 4: This response by the nurse is correct since the first dose of varicella vaccine
cannot be given until 12 to 15 months of age.
Global Rationale: The first dose of varicella vaccine is given at 12 to 15 months of
age. Providing the vaccine prior to that time is contraindicated.
Cognitive Level: Applying
Client Need: Physiological Integrity
Client Need Sub: Pharmacological and Parenteral Therapies
QSEN Competencies: III.B.3. Base individualized care plan on patient values,
clinical expertise, and evidence.
AACN Essentials Competencies: VII.11. Participate in clinical prevention and populationfocused interventions with attention to effectiveness, efficiency, cost-effectiveness, and equity.

D’Amico/Barbarito Health & Physical Assessment in Nursing, 3/e
Copyright 2016 by Pearson Education, Inc.


NLN Competencies: Context and Environment: Apply health
promotion/disease prevention strategies; Apply health policy.
Nursing/Integrated Concepts: Nursing Process: Planning
Learning Outcome: 3.4: Apply the goals and objectives for each topic area in Healthy People
2020 to nursing practice.
MNL Learning Outcome:
Page Number: pp. 58–61
Question 23
Type: MCSA
The nurse is performing a health assessment. Which of the questions will provide
the greatest assistance in the determination of discharge planning needs?
1. “Do you live alone?”
2. “Did you graduate from high school?”
3. “Are you involved in any types of exercise programs?”
4. “What steps have you taken to ensure your care when you go home?”
Correct Answer: 4
Rationale 1: This question is a closed question that limits the responses of the client to a
“yes” or “no” answer, and will prevent the nurse from determining the discharge planning
needs of this client.
Rationale 2: This question is a closed question that limits the response of the client to a “yes”
or “no” answers, and will prevent the nurse from determining discharge-planning needs of this
client.
Rationale 3: Information regarding whether or not the client is involved in an exercise
program will not help the nurse in determining the client’s discharge planning needs.
Rationale 4: “What steps have you taken to ensure your care when you go home?” is an openended question that will allow the nurse to determine the client’s discharge planning needs.

Global Rationale: Open-ended questions will solicit the greatest amount of information for
discharge planning needs. Options 1 and 2 represent closed questions. The determination of
participation in exercise programs will not provide information concerning discharge-planning
needs.
Cognitive Level: Applying
Client Need: Health Promotion and Maintenance
Client Need Sub:
QSEN Competencies: III.B.3. Base individualized care plan on patient values,
clinical expertise, and evidence.
AACN Essentials Competencies: VII.5. Use evidence-based practices to guide health
teaching, health counseling, screening, outreach, disease and outbreak investigation,
referral, and follow-up throughout the lifespan.
NLN Competencies: Context and Environment: Apply health promotion/disease
prevention strategies; Apply health policy;
Nursing/Integrated Concepts: Nursing Process: Planning
Learning Outcome: 3.5: Demonstrate how to use the nursing process to encourage
health promotion.
MNL Learning Outcome:
Page Number: pp. 49–54
D’Amico/Barbarito Health & Physical Assessment in Nursing, 3/e
Copyright 2016 by Pearson Education, Inc.


Question 24
Type: MCSA
A group of clients attend an educational program at which prevention and screening activities
for breast cancer is discussed. Using the Health Belief Model, which participant is most likely
to engage in the available health screenings?
1. The client whose mother and grandmother have a history of breast cancer.
2. The client who is attending the program as a course requirement.

3. The client attending in support of the presenter.
4. The client who agreed to attend in support of another
participant. Correct Answer: 1
Rationale 1: According to the Health Belief Model, mediating variables determine the
likelihood of an individual to actively participate in prevention of illness. The client whose
family members have a history of breast cancer is most vulnerable to the disease and is thus most
likely to engage in the available health screenings.
Rationale 2: According to the Health Belief Model, the client who is attending the program
as a course requirement will be less influenced to participate in the health screenings than the
client who has the positive family history of breast cancer.
Rationale 3: According to the Health Belief Model, the client who is attending the program
in support of the presenter will be less influenced to participate in the health screenings
than the client who has the positive family history of breast cancer.
Rationale 4: According to the Health Belief Model, the client who agreed to attend the
program in support of another participant will be less influenced to participate in the
health screenings than the client who has the positive family history of breast cancer.
Global Rationale: According to the Health Belief Model, mediating variables determine the
likelihood of an individual to actively participate in prevention of illness. The client whose
family members have a history of breast cancer is most vulnerable to the disease and is thus most
likely to engage in the available health screenings. The remaining participants do not have the
same high level of mediating factors to influence their participation. The client who is attending
the program as a course requirement will be less influenced to participate in the health
screenings than the client who has the positive family history of breast cancer. Similarly, the
client who is attending the program in support of the presenter and the client who agreed to
attend the program in support of another participant will be less influenced to participate in the
health screenings than the client who has the positive family history of breast cancer.
Cognitive Level: Analyzing
Client Need: Health Promotion and Maintenance
Client Need Sub:
QSEN Competencies: III.B.3. Base individualized care plan on patient values,

clinical expertise, and evidence.
AACN Essentials Competencies: I.1. Integrate theories and concepts from liberal
education into nursing practice.
NLN Competencies: Context and Environment: Health promotion/disease prevention.
Nursing/Integrated Concepts: Nursing Process: Evaluation
Learning Outcome: 3.3: Relate perspectives of health promotion to the individual, family, and
community.
MNL Learning Outcome:
D’Amico/Barbarito Health & Physical Assessment in Nursing, 3/e
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Page Number: pp. 49–50
Question 25
Type: MCSA
The nurse is counseling an adult client who has been instructed by the healthcare provider
to have a mammogram screening performed. The nurse outlines this procedure for the client
as which type of prevention?
1. Primary.
2. Tertiary.
3. Prepathologic.
4. Secondary.
Correct Answer: 4
Rationale 1: Primary prevention implies health and high-level wellness prior to the development
of a disease or pathology. Examples of primary prevention include immunizations and eating a
healthy diet. Screening mammograms are considered secondary prevention.
Rationale 2: Tertiary prevention occurs following the development of a disease or pathologic
condition and is aimed at restoring an individual to the highest level of health possible. An
example of tertiary prevention would be physical rehabilitation therapy for a client who has
had a stroke. Screening mammograms are considered secondary prevention.

Rationale 3: Prepathologic prevention is the same as primary prevention, which implies health
and high-level wellness prior to the development of a disease or pathology. Examples of
primary prevention include immunizations and eating a healthy diet. Screening mammograms
are considered secondary prevention.
Rationale 4: The goals of secondary prevention are early diagnosis and prompt treatment
of health problems. Examples of secondary prevention include screenings such as
mammograms, blood tests, surgery, and dental care.
Global Rationale: Secondary prevention involves early diagnosis of health problems. Due to
an increased risk of breast cancer in women over 50, routine screening is recommended yearly.
Screening mammograms are considered secondary prevention. Other examples of secondary
prevention include screenings such as blood tests, surgery, and dental care. Prepathologic is
another name for primary prevention, which implies health and high-level functioning prior to
development of pathology. Examples of primary prevention include immunizations and eating
a healthy diet. Tertiary prevention occurs following the development of a disease or pathologic
condition and is aimed at restoring an individual to the highest level of health possible. An
example of tertiary prevention would be physical rehabilitation therapy for a client who has had
a stroke.
Cognitive Level: Remembering
Client Need: Health Promotion and Maintenance
Client Need Sub:
QSEN Competencies: III.A.1. Demonstrate knowledge of basic scientific methods
and processes.
AACN Essentials Competencies: I.1. Integrate theories and concepts from liberal
education into nursing practice.
NLN Competencies: Context and Environment: Health promotion/disease prevention.
Nursing/Integrated Concepts: Nursing Process: Diagnosis
Learning Outcome: 3.2: Compare and contrast selected theories of wellness.
D’Amico/Barbarito Health & Physical Assessment in Nursing, 3/e
Copyright 2016 by Pearson Education, Inc.

MNL Learning Outcome:
Page Number: p. 48
Question 26
Type: MCMA
The nurse is planning to develop a campaign to raise awareness on the benefits of
regular physical activity. Based on Healthy People 2020 reports, the nurse should target
which populations?
Standard Text: Select all that apply.
1. Individuals of Hispanic descent attending English as a Second Language course.
2. Individuals who are enrolled in a master’s degree program at a local college.
3. Females attending a mother’s support group ranging from ages 25 to 35 years.
4. Males employed at an investment company ranging from ages 35 to 45 years.
5. Adolescents participating in after-school programs for low-income
families. Correct Answer: 1, 3, 5
Rationale 1: These individuals fall into one of the groups identified by Healthy People 2020 as
getting less physical activity than other populations.
Rationale 2: These individuals do not fall into one of the groups identified by Healthy
People 2020 as getting less physical activity than other populations.
Rationale 3: These individuals fall into one of the groups identified by Healthy People 2020 as
getting less physical activity than other populations.
Rationale 4: These individuals do not fall into one of the groups identified by Healthy
People 2020 as getting less physical activity than other populations.
Rationale 5: These individuals fall into one of the groups identified by Healthy People 2020 as
getting less physical activity than other populations.
Global Rationale: According to reports in Healthy People 2020, individuals who get the least
amount of physical activity include women, lower income and lower educated populations,
and African American and Hispanic populations. Therefore, the nurse would be most effective
in targeting the individuals of Hispanic descent who are attending English as a Second
Language course, the group of females attending a mother’s support group, and the

adolescents participating in after school programs for low-income families.
Cognitive Level: Applying
Client Need: Health Promotion and Maintenance
Client Need Sub:
QSEN Competencies: III.B.3. Base individualized care plan on patient values,
clinical expertise, and evidence.
AACN Essentials Competencies: VII.11. Participate in clinical prevention and
population-focused interventions with attention to effectiveness, efficiency, costeffectiveness, and equity. NLN Competencies: Context and Environment: Apply health
promotion/disease prevention strategies; Apply health policy.
Nursing/Integrated Concepts: Nursing Process: Implementation
Learning Outcome: 3.4: Apply the goals and objectives for each topic area in Healthy People
2020 to nursing practice.
MNL Learning Outcome:
Page Number: pp. 54–66

D’Amico/Barbarito Health & Physical Assessment in Nursing, 3/e
Copyright 2016 by Pearson Education, Inc.


Question 27
Type: MCSA
The nurse is working with an older adult client who has osteoarthritis that affects the
mobility of both hips. In developing a plan of care, the nurse must consider the recommended
levels of physical activity according to the Center for Disease Control (CDC). Which goal is
the most appropriate for this client?
1. The client will bicycle at 10 mph for 1 hour or more every day.
2. The client will jog for 15 minutes per day 5 days per week.
3. The client will walk at least 5 mph for 15 minutes per day.
4. The client will swim for 15 minutes per day 5 days per
week. Correct Answer: 4

Rationale 1: Bicycling at 10 mph for 1 hour or more every day is considered vigorous
physical activity according to the CDC guidelines, and would most likely place excess
strain on the client’s hip joints that are affected by the osteoarthritis.
Rationale 2: Jogging for 15 minutes per day 5 days per week is considered vigorous
physical activity according to the CDC guidelines, and would place excess strain on the
client’s hip joints that are affected by the osteoarthritis.
Rationale 3: Walking at least 5 mph for 15 minutes per day is considered vigorous
physical activity according to the CDC guidelines, and would most likely place excess
strain on the client’s hip joints that are affected by the osteoarthritis.
Rationale 4: The CDC recommends that older adults follow the same guidelines for physical
activity as adults (moderate intensity physical activity at least 2 hours and 30 minutes per
week or 1 hour and 15 minutes of vigorous activity or a combination of moderate and vigorous
physical activity per week); if chronic conditions cause limitations, older adults should
participate in as much physical activity as their condition allows. Swimming would place the
least amount of strain on the hip joints affected by the osteoarthritis, and 15 minutes per day 5
days per week is moderate physical activity that would help maintain joint mobility.
Global Rationale: The CDC recommends that older adults follow the same guidelines for
physical activity as adults (moderate intensity physical activity at least 2 hours and 30 minutes
per week or 1 hour and 15 minutes of vigorous activity, or a combination of moderate and
vigorous physical activity per week); if chronic conditions cause limitations, older adults
should participate in as much physical activity as their condition allows. Swimming would
place the least amount of strain on the hip joints affected by the osteoarthritis, and 15 minutes
per day 5 days per week is moderate physical activity that would help maintain joint mobility.
The options of bicycling, jogging, and walking at the paces described would be considered
vigorous physical activity and would place strain on the client’s hips.
Cognitive Level: Applying
Client Need: Health Promotion and Maintenance
Client Need Sub:
QSEN Competencies: III.B.3. Base individualized care plan on patient values,
clinical expertise, and evidence.

AACN Essentials Competencies: VII.5. Use evidence-based practices to guide health
teaching, health counseling, screening, outreach, disease and outbreak investigation,
referral, and follow-up throughout the lifespan.
NLN Competencies: Context and Environment: Apply health promotion/disease
prevention strategies; Apply health policy.
D’Amico/Barbarito Health & Physical Assessment in Nursing, 3/e
Copyright 2016 by Pearson Education, Inc.